{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:55:38Z","timestamp":1781772938518,"version":"3.54.5"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"\n Background<\/jats:title>\n Robot-assisted task conditions incorporating Active Movement Mode (AMM) and Mirror Therapy Mode (MTM) is widely used for upper-limb stroke rehabilitation. However, their differential task-related cortical responses remain insufficiently characterized.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to use functional near-infrared spectroscopy (fNIRS) to characterize and compare the task-dependent cortical activation and rest state functional connectivity profiles elicited by AMM and MTM in stroke patients and healthy controls.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Twenty-three chronic stroke patients and twenty-three matched healthy controls performed robot-assisted upper limb tasks in both AMM and MTM. Cortical activation (Beta value) in the prefrontal (PFC), primary motor (M1), supplementary motor (SMA), premotor (PMC), and primary somatosensory (PSC) cortices was measured using a 48-channel fNIRS system. A Two-way repeated measures ANOVA to compare cortical activation; Hemispheric activation distribution was assessed by calculating the lateralization index (LI). To evaluate brain-behavior relationships, we used Pearson or Spearman correlation analyses to examine the association between ROI activation levels and FMA-UE scores. Furthermore, resting-state functional connectivity (RSFC) was compared between eyes-open and eyes-closed conditions. All multiple comparisons were corrected using the Benjamini-Hochberg FDR method.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Both groups showed extensive cortical activation across both modes (\n \n \n p<\/mml:mi>\n <<\/mml:mo>\n 0.01<\/mml:mn>\n <\/mml:math>\n <\/jats:inline-formula>\n ). Analysis of variance indicated significant main effects of task in the ipsilesional PFC and PSC, along with the contralesional PFC and PMC (\n \n \n p<\/mml:mi>\n <<\/mml:mo>\n 0.05<\/mml:mn>\n <\/mml:math>\n <\/jats:inline-formula>\n ), where activation in the AMM mode was consistently higher than in the MTM mode. Resting-state analysis revealed that stroke patients had significantly weaker inter-hemispheric and intra-hemispheric RSFC in the eye-open (EO) condition than healthy controls (\n \n \n p<\/mml:mi>\n <<\/mml:mo>\n 0.05<\/mml:mn>\n <\/mml:math>\n <\/jats:inline-formula>\n ). No significant correlations between brain activity and behavior or lateralization effects were found.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Active Movement Mode and Mirror Therapy Mode exhibited distinct cortical activation and functional connectivity profiles during robot-assisted upper-limb tasks. Compared with MTM, AMM was associated with stronger recruitment of several motor-related regions, while differences in connectivity further supported distinct modes of neural engagement.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n Unique identifier: ChiCTR2500096992, URL:\n https:\/\/www.chictr.org.cn<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fneur.2026.1766545","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:34:35Z","timestamp":1781771675000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential cortical responses of robot-assisted active and mirror therapy task conditions in stroke patients and healthy controls: a comparative fNIRS study"],"prefix":"10.3389","volume":"17","author":[{"given":"Changhao","family":"Le","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huamin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiarong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huali","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjian","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Rehabilitation Laboratory, Hengyang Medical School, the First Affiliated Hospital of University of South China","place":["Hengyang, Hunan, China"]},{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University","place":["Kowloon, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1016\/S0140-6736(11)60325-5","article-title":"Stroke rehabilitation","volume":"377","author":"Langhorne","year":"2011","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e032413","DOI":"10.1136\/bmjopen-2019-032413","article-title":"Effectiveness of interventions to improve hand motor function in individuals with moderate to severe stroke: a systematic review protocol","volume":"9","author":"Wang","year":"2019","journal-title":"BMJ Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"12739","DOI":"10.3390\/ijerph191912739","article-title":"Effectiveness of rehabilitation exercise in improving physical functio n of stroke patients: a systematic review","volume":"19","author":"Lee","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1080\/16501970410023434","article-title":"Effects of passive-active movement training on upper limb motor function and cortical activation in chronic patients with stroke: a pilot study","volume":"36","author":"Lindberg","year":"2004","journal-title":"J Rehabil Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1589\/jpts.28.1876","article-title":"Analysis of scapular kinematics during active and passive arm elevation","volume":"28","author":"Kai","year":"2016","journal-title":"J Phys Ther Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/strokeaha.112.673087","article-title":"Mirror therapy for improving motor function after stroke","volume":"44","author":"Thieme","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e01489","DOI":"10.1002\/brb3.1489","article-title":"Cortical mapping of mirror visual feedback training for unilateral upper extremity: a functional near-infrared spectroscopy study","volume":"10","author":"Bai","year":"2020","journal-title":"Brain Behav"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1498","DOI":"10.1016\/j.apmr.2023.02.004","article-title":"Efficacy of robot-assisted training on rehabilitation of upper limb function in patients with stroke: a systematic review and Meta-analysis","volume":"104","author":"Yang","year":"2023","journal-title":"Arch Phys Med Rehabil"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"101789","DOI":"10.1016\/j.rehab.2023.101789","article-title":"Resistive versus active assisted robotic training for the upper limb a fter a stroke: a randomized controlled study","volume":"67","author":"Jeon","year":"2024","journal-title":"Ann Phys Rehabil Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1602896","DOI":"10.3389\/fneur.2025.1602896","article-title":"Combination of robot-assisted glove and mirror therapy improves upper limb motor function in subacute stroke patients: a randomized controlled pilot study","volume":"16","author":"Qian","year":"2025","journal-title":"Front Neurol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"147935","DOI":"10.1016\/j.brainres.2022.147935","article-title":"Cortical mapping of active and passive upper limb training in stroke patients and healthy people: a functional near-infrared spectroscopy study","volume":"1788","author":"Xia","year":"2022","journal-title":"Brain Res"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"260","DOI":"10.3389\/fnhum.2020.00260","article-title":"Cortical activation during shoulder and finger movements in healthy adults: a functional near-infrared spectroscopy (fNIRS) study","volume":"14","author":"Yang","year":"2020","journal-title":"Front Hum Neurosci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1136\/jnnp.2009.194134","article-title":"The neuronal correlates of mirror therapy: an fMRI study on mirror induced visual illusions in patients with stroke","volume":"82","author":"Michielsen","year":"2011","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e0293394","DOI":"10.1371\/journal.pone.0293394","article-title":"Distinct age-related brain activity patterns in the prefrontal cortex when increasing cognitive load: a functional near-infrared spectroscopy study","volume":"18","author":"Ranchod","year":"2023","journal-title":"PLoS One"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.ijpsycho.2018.11.006","article-title":"Monitoring multiple cortical regions during walking in young and older adults: dual-task response and comparison challenges","volume":"135","author":"Stuart","year":"2019","journal-title":"Int J Psychophysiol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"19609","DOI":"10.1038\/s41598-023-46645-4","article-title":"Neural correlates of weight-shift training in older adults: a randomized controlled study","volume":"13","author":"de Rond","year":"2023","journal-title":"Sci Rep"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.neuroimage.2013.05.004","article-title":"A review on continuous wave functional near-infrared spectroscopy and imaging instrumentation and methodology","volume":"85","author":"Scholkmann","year":"2014","journal-title":"NeuroImage"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.neuroimage.2018.09.025","article-title":"Temporal derivative distribution repair (TDDR): a motion correction method for fNIRS","volume":"184","author":"Fishburn","year":"2019","journal-title":"NeuroImage"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"034004","DOI":"10.1117\/1.3127204","article-title":"Wavelet minimum description length detrending for near-infrared spectroscopy","volume":"14","author":"Jang","year":"2009","journal-title":"J Biomed Opt"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.neuroimage.2008.08.036","article-title":"NIRS-SPM: statistical parametric mapping for near-infrared spectroscopy","volume":"44","author":"Ye","year":"2009","journal-title":"NeuroImage"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/s1474-4422(13)70264-3","article-title":"Connectivity-based approaches in stroke and recovery of function","volume":"13","author":"Grefkes","year":"2014","journal-title":"Lancet Neurol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/ana.10848","article-title":"Influence of interhemispheric interactions on motor function in chronic stroke","volume":"55","author":"Murase","year":"2004","journal-title":"Ann Neurol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.1093\/brain\/awr039","article-title":"Harnessing neuroplasticity for clinical applications","volume":"134","author":"Cramer","year":"2011","journal-title":"Brain"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12984-024-01374-1","article-title":"Video mirror feedback induces more extensive brain activation compared to the mirror box: an fNIRS study in healthy adults","volume":"21","author":"Bonnal","year":"2024","journal-title":"J Neuroeng Rehabil"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1016\/j.clinph.2006.01.016","article-title":"Arm function after stroke: neurophysiological correlates and recovery mechanisms assessed by transcranial magnetic stimulation","volume":"117","author":"Talelli","year":"2006","journal-title":"Clin Neurophysiol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1080\/02699050802635299","article-title":"A longitudinal study of functional magnetic resonance imaging in upper-limb hemiplegia after stroke treated with constraint-induced movement therapy","volume":"23","author":"Sheng","year":"2009","journal-title":"Brain Inj"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s10548-011-0201-2","article-title":"Plasticity in cortical motor upper-limb representation following stroke and rehabilitation: two longitudinal multi-joint FMRI case-studies","volume":"25","author":"Stark","year":"2012","journal-title":"Brain Topogr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1097\/WNR.0000000000001615","article-title":"Effects of passive and active training modes of upper-limb rehabilitation robot on cortical activation: a functional near-infrared spectroscopy study","volume":"32","author":"Zheng","year":"2021","journal-title":"Neuroreport"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3233\/NRE-230355","article-title":"Effects of robot-assisted upper limb training combined with intermittent theta burst stimulation (iTBS) on cortical activation in stroke patients: a functional near-infrared spectroscopy study","volume":"54","author":"Dai","year":"2024","journal-title":"NeuroRehabilitation"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1038\/nrn.2017.14","article-title":"Sense of agency in the human brain","volume":"18","author":"Haggard","year":"2017","journal-title":"Nat Rev Neurosci"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"722846","DOI":"10.3389\/fneur.2021.722846","article-title":"Task complexity and image clarity facilitate motor and visuo-motor activities in mirror therapy in post-stroke patients","volume":"12","author":"Bello","year":"2021","journal-title":"Front Neurol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1995","DOI":"10.1038\/s41598-018-37912-w","article-title":"Belief of agency changes dynamics in sensorimotor networks","volume":"9","author":"Buchholz","year":"2019","journal-title":"Sci Rep"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"107456","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107456","article-title":"Prefrontal cortex activity of active motion, cyclic electrical muscle stimulation, assisted motion, and imagery of wrist extension in stroke using fNIRS","volume":"32","author":"Lu","year":"2023","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.cnp.2024.12.004","article-title":"Motor and parietal cortex activity responses to mirror visual feedback in patients with subacute stroke: an EEG study","volume":"10","author":"Zhuang","year":"2025","journal-title":"Clin Neurophysiol Pract"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e00320","DOI":"10.1016\/j.neurot.2024.e00320","article-title":"Evidence of mirror therapy for recruitment of ipsilateral motor pathways in stroke recovery: a resting fMRI study","volume":"21","author":"Zhang","year":"2024","journal-title":"Neurotherapeutics"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s13063-017-2205-z","article-title":"Effects of action observation therapy and mirror therapy after stroke on rehabilitation outcomes and neural mechanisms by MEG: study protocol for a randomized controlled trial","volume":"18","author":"Shih","year":"2017","journal-title":"Trials"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1016\/j.brainresbull.2021.10.003","article-title":"Mirror therapy in upper limb motor recovery and activities of daily living, and its neural correlates in stroke individuals: a systematic review and meta-analysis","volume":"177","author":"Nogueira","year":"2021","journal-title":"Brain Res Bull"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1177\/1545968314546134","article-title":"Reflections on mirror therapy: a systematic review of the effect of mirror visual feedback on the brain","volume":"29","author":"Deconinck","year":"2015","journal-title":"Neurorehabil Neural Repair"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13216612","article-title":"Applications of near infrared spectroscopy and mirror therapy for upper limb rehabilitation in post-stroke patients: a brain plasticity pilot study","volume":"13","author":"Formica","year":"2024","journal-title":"J Clin Med"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"593","DOI":"10.3233\/NRE-130999","article-title":"Cerebral activation evoked by the mirror illusion of the hand in stroke patients compared to normal subjects","volume":"33","author":"Wang","year":"2013","journal-title":"NeuroRehabilitation"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1111\/nyas.13948","article-title":"The present and future use of functional near-infrared spectroscopy (fNIRS) for cognitive neuroscience","volume":"1464","author":"Pinti","year":"2020","journal-title":"Ann N Y Acad Sci"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1766545\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T08:34:36Z","timestamp":1781771676000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2026.1766545\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":41,"alternative-id":["10.3389\/fneur.2026.1766545"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2026.1766545","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"article-number":"1766545"}}